Individual
DR. ALLYSON W MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2 MEDICAL PARK RD STE 306, COLUMBIA, SC 29203-6839
(803) 256-2657
Mailing address
923 LEXINGTON AVE, FORT SMITH, AR 72901-4943
(479) 709-7350
(479) 709-7355
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0116020110
VA
208600000X
Surgery Physician
Primary
E8287
AR
208600000X
Surgery Physician
LL34981
SC
Other
Enumeration date
05/12/2008
Last updated
04/12/2016
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